Lazenby Mark, Ercolano Elizabeth, Grant Marcia, Holland Jimmie C, Jacobsen Paul B, McCorkle Ruth
Yale University School of Nursing, New Haven, CT; City of Hope, Duarte, CA; Memorial Sloan Kettering Cancer Center, New York, NY; and Moffitt Cancer Center, Tampa, FL
Yale University School of Nursing, New Haven, CT; City of Hope, Duarte, CA; Memorial Sloan Kettering Cancer Center, New York, NY; and Moffitt Cancer Center, Tampa, FL.
J Oncol Pract. 2015 May;11(3):e413-20. doi: 10.1200/JOP.2014.002816. Epub 2015 Mar 10.
The American College of Surgeons Commission on Cancer (CoC) has set psychosocial distress screening as a new patient care standard to be met by 2015. The standard requires CoC-accredited cancer centers to integrate and monitor distress screening and, when needed, refer patients to psychosocial health care services. We describe the uptake of distress screening reported by applicants to a distress screening cancer education program and the degree of and barriers to implementation of distress screening programs reported by selected participants.
This cross-sectional study collected quantitative data online from applicants to the program between August 1 and November 15, 2013, described by frequencies, percentages, and measures of central tendency, and qualitative data in person from accepted participants on February 13, 2014, analyzed using an integrated approach to open-ended data.
Applications were received from 70 institutions, 29 of which had started distress screening. Seven of 18 selected applicant institutions had not begun screening patients for distress. Analysis of qualitative data showed that all participants needed to create buy-in among key cancer center staff, including oncologists; to decide how to conduct screening in their institution in a way that complied with the standard; and to pilot test screening before large-scale rollout.
Fourteen months before the compliance deadline, fewer than half of applicant institutions had begun distress screening. Adding implementation strategies to mandated quality care standards may reduce uncertainty about how to comply. Support from key staff members such as oncologists may increase uptake of distress screening.
美国外科医师学会癌症委员会（CoC）已将心理社会困扰筛查设定为一项新的患者护理标准，要求到2015年达到这一标准。该标准要求获得CoC认证的癌症中心整合并监测困扰筛查情况，并在需要时将患者转介至心理社会保健服务机构。我们描述了参加一项困扰筛查癌症教育项目的申请者所报告的困扰筛查采用情况，以及部分参与者所报告的困扰筛查项目实施程度和实施障碍。
这项横断面研究于2013年8月1日至11月15日在线收集项目申请者的定量数据，以频率、百分比和集中趋势指标进行描述，并于2014年2月13日亲自收集入选参与者的定性数据，采用开放式数据综合分析方法进行分析。
共收到70家机构的申请，其中29家已开始进行困扰筛查。在18家入选的申请机构中，有7家尚未开始对患者进行困扰筛查。定性数据分析表明，所有参与者都需要在包括肿瘤学家在内的癌症中心关键工作人员中获得支持；需要决定如何在其机构内以符合标准的方式进行筛查；并需要在大规模推广之前进行筛查试点测试。
在合规截止日期前14个月，不到一半的申请机构已开始进行困扰筛查。在强制性质量护理标准中增加实施策略可能会减少如何合规的不确定性。肿瘤学家等关键工作人员的支持可能会提高困扰筛查的采用率。
